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HomeMy WebLinkAboutT13N R3W SEC 13 Lot 5 of 26 · ~ . ¢;~ GRF-. ~ER AK!CHORAGE AREA BO.. ~)UGH ~ /~Jl~]~'~' ~ ~ DEPARTMENT OF ENVIRONMENTAL QUALITY W . ;: EM ~ APPLICATIO~ AND NAME OF APPLICANT . MAILING ADDRESS PERM'TNO. INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS TO BE INSTALLED BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, SEPTIC TANK S~ZE TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANt;ES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE Pit , DRA[N FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT ~ DRAIN FIELD TO NEAREST LOT LINE. DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE. STREAM. CAST IRON {NTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION ~ FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE P~T FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEl. BACKFILL CONFORM TO BOROUGH REGULATION! ~DING INSTALLATION. DIAGRAM OF SYSTEM DESCRIBED St IS IN ACCORDANCE WITH SAID CODe.I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER~ ~~//~/~/ANCHORAGE OROUGH ORDINANCE NO. 28-6B AND THAT THE ABOVE DATE APPLICANT'S SIGNATURE ~. EQ-016{3-7§} WELL DQNSTRUDTION LOG Well location: (address & legal description)~ USD$ eD. Oate well completed / Nearest community Location sketch ~'r renarks g%Vm' ~ 7:) - /-~'-~'-1~ diam. ~ Static water I.vel ~(~) ( ~n%~d perlorateP, open-hole other) Finish of well: ~ :~ screen, , Describe intervals and size: Well yield tested by (~) baili.g, air) at ~ ~ for ~/ hours with / it, of drawdowc fram static level. ft. (:~, below) lend surface. gal/min, DRILLER'S MATERIAL LOG Depth below land Dive description of strata penetrated surface in feet (size of material, color, hardness of drilling, and water content) --tO --tO mto --.to to-- to, to · ~ ,.~. ~. ~ ?~MUNICIPALII~¥ OF AN,CHORAGF'~'~ ~:X, :~ ~i~DE~P, ARTMEN-i,, ..F: HEA~T~'~AN~ EN~I~R~NMENTA'L .~ROTECTION~ ?~ ~ ~~,~;~ '~ 825-L St=eet, ~h~'~-a'ge, AlaSka ' 99501 Date Received: ~A ~)/~, 1st Inspection: Time ~:~__~ 2nd Inspection: Time /I,'~O~~ Date .~-~ 7 ~3S, Date ~! -~ ~7 ~ ~/LZ~D$'  Inspector ~dY~ Inspector. ~ ~ ~-~-/~ ~ ~ ~ ~ sQussT FOe A P OVAm OF INDIVIDUAL SeWeR Lending Institution Request: First National B~k of ~cho~age Mailing Address: Post Office Box 720 99510 Phone: 276-6300 2. Property Owner: Gerald/Dorothy Nix Mailing Address; 8433 Peck Avenue Phone: 333-6007 3. Legal Description: T13N R3W Section 13 Lot 5 of Lot 26 8433 Peck Avenue 4. Single Family Residence: (x) Number of Bedrooms: Multiple F~ily Residence: ( ) Number of Bedrooms: 5. Well Data: Type Semi-pUblic Depth 160' Well Log Filed ( ) Construction Bacterial Analysis 6. Sewage Disposal System: On-site system ( ) Public Utility (x) Permit ~ Installed Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material Distances: Well ~o Septic Tank to Sewer Lines Nearest Lot Line Absorption Area to Nearest Lot Line to kbsorption Area ~'MUNICIPALITY OF ANCHORAG~ ) ~tment of Health and Environmenta~ Pro~tec~ion~\'%/~\ .~' 825 L Street, Anchorage, Alaska 99301 279-2511, ext. 224, 225 ~equest~.~or Approval of Individual Sewer and Water Facilities Mailing Address: ~9 3 3 ~ ~c ~ F~ Phone:~.~ ~-~ Name of Buyer: Mailing Address: Lending Institution: Mailing Address: Phone: Realtor/Agent: Mailing Address Legal Description: Street Location: Single Family Residence: (~ Number of Bedrooms: Multiple Family Residence: ( Number of Bedrooms: 7. Water Supply: * Individual Well Q<) Public/Community System ( If Individual Well, well depth /~ (~ If Community System~ name of system _ ~ ?..~, ,, ~ Sewage Disposal System: On-site System ( ) Public System If On-site System, date of installation: *NOTE:' A well log is required on ALL wells drilled since 6/75. 3/77 .', ', Department of Health and Environmental Protection '. ~ kequest for Approval of Individual Sewer and Water Facilities Legal Description: T13N R3W Section 13 Lot 5 Of Lot 26 Comments: Affadavit Attached: (~ /% ~ .~etter Attac.,hed~ ( ) // o~ _ (_J..4._ ~.~, Disapproved: Date: Department Worksheet: '"°' /4~ ~ OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF I:~ALTH r.&r REQU DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOL~¥iEONMENTAL F~OT~TJO~ 825 L Street - Anchorage, Alaska 99501 ' ' ENVIRONMENTAL ENGINEERING DIVISION MAR 2 2 1979 n DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP RTYOWNER PHONE MAI LING A DDR ESS PROPERTY RESIDENT (If different from above) 2. BUYER PHONE PHONE MAILING ADDRESS ..7503 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ One ~ Four ~ SINGLE FAMILY ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER SUPPLY I~ INDIVIDUAL* * ATTACH WELL LOG. A well log is requ'ired for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON-SITE** **If individual/on-site, give installation date . ;;~;.~;~...; ...... :;.~ ~2', , ~_:. _!2 cc :2:;:?_-,,! +~,, ? ~7 ..... ' ~ PUBLIC UTILITY I~. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~O10(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTOR D~RECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVl DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~ APPROVED FOR ~'"~ BEDROOMS [] CONDITIONAL APPROVAL (better must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION J 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE 0, Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 006-042-36-000 Legal description T1 3N R3W SEC 13 LT 5 OF 26 Site address 8433 PECK AVE Anchorage AK 99504 Expiration Date: Current property owner(s) DUCHARME JOHNATHAN S 11/25/2023 X The On-site system(s) is/are approved for 1 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 8/25/2023 ;Phis Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) islare in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 006-042-36 Complete legal description T13N R3W Sec 13 Lot 5 of 26 Location (site address) 8433 Peck Ave. Anchorage, AK Current property owner(s) Johnathan Ducharme 2. ON-SITE SYSTEMS SIZED FOR 1 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: V Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank © Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: [ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ l Waiver Fee $ Date of Payment 8 i-iA Date of Payment COSA # 0 S C 2 3 13 TL Waiver # COSA Application—June 2022 Legal Description: COSA Checklist T13N R3W Sec 13 Lot 5 of 26 Parcel ID: 1721CQ If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ✓❑ Well log is filed with Onsite (or attached) Date drilled 4/23/71 _Total depth 104 ft Cased to 104 ft Sanitary seal is functioning correctly ✓❑ Wires are properly protected Casing. height (above ground) 9 in. Date of flow test for COSA 8/16/23 Static water level at beginning of test 30 ft. Comments DATA Measured operating flus tic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: . ABSORPTION FIELD DATA Which s em tested (date installed) ❑ ALL standpi present per record drawing Total measured depth grade ft (max) Measured depth to pipe inve m grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insula ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced _gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies COSA Checklist June 2022 Well production at time of test 2.1 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ✓❑ N ✓❑ Coliform bacteria is Negative Nitrate 1.27 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ✓❑ Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 8/8/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station ma Comments Adequacy test date Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd LD STATUS — POST RECOVERY Effects depth (per record drawings) in Effective dep sed In Effective depth remal in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Building Foundatio _ ❑ Yes Community Sewer Manhole/Cleanout > 100' F-1 Yes if No NA ft ✓❑ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ✓❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' ✓❑ Yes if No ft Neighboring Absorption Fields > 100' ❑ Yes if No Animal Containment > 50' Q Yes if No ft ❑✓ Yes if No ft if No ft If tank or field is under driveway ent below F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑ Yes if No ft ❑✓ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water 5epticlHolding Tank and Absorption Fields) on Lot to: (Please enter distances if less than required) Building Foundatio _ ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Tank to Property Line > 5' ❑ Yes i ❑ ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' [-]Yes if No ft Water Main > 10' ❑ Yes if No ft Commum s > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway ent below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Arcterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date / .? Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. �r-F -w. ijj The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The �*♦P��*� now and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year 41, �i 1 and the water usage of the family being served by the system. The operational life of all well and septic w "1 g systems are subject to these various and dynamic characteristics and are outside the control of the evaluator, of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will r function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. G- KENNETH FUS 4 f j CE 7 �4! ESS1C>`�*� COSA Checklist -June 2022 LOT 8 S 89055'00" W 50.00' UTILITY " OVERHEAD UTILITY LINE EO— POLE rr EO_EO�EO�EO� —E .�OXXXX X X- 10' UTILITY EASEMENT 18.8' 9.0' o_ o 9.0' WELL 1�, GRAVEL DRIVEWAY N 89055'00" E 50.00' PIPE X X X X XJ M M Co Cl) - - PECK AVENUE- - -- EASEMENTS - EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (P -257B) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR IS A VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. JOB # 23131 I NO CORNERS SET THIS DATE I SCALE 1" -- 20 0 10' 20' AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 5, GOVERNMENT LOT 26, SECTION 13, T 13 N, R 3 W, SEWARD MERIDIAN ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 21st DAY OFAUGUST, 2023, ATANCHORAGE, ALASKA. FIXED HEIGHT, LLC C.O.A.122554 Land Surveying Services 907.290.8949 225 W 23rd Ave., Anchorage, AK 99503 WWW. FIXEDHEIGHT COM x I x I LOT 5 6,675 sq. ft. 0 0 O x Z CoI oo C:) o 0 0 Co m x O LOT 4 W W x � LOT 6 Ul O x W x 6.5' 18.0' m�\ N m SEWER p -A CLEANOUTti 18.8' w N 1 -STORY o FRAME HOUSE 18.8' 9.0' o_ o 9.0' WELL 1�, GRAVEL DRIVEWAY N 89055'00" E 50.00' PIPE X X X X XJ M M Co Cl) - - PECK AVENUE- - -- EASEMENTS - EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (P -257B) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR IS A VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. JOB # 23131 I NO CORNERS SET THIS DATE I SCALE 1" -- 20 0 10' 20' AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 5, GOVERNMENT LOT 26, SECTION 13, T 13 N, R 3 W, SEWARD MERIDIAN ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 21st DAY OFAUGUST, 2023, ATANCHORAGE, ALASKA. FIXED HEIGHT, LLC C.O.A.122554 Land Surveying Services 907.290.8949 225 W 23rd Ave., Anchorage, AK 99503 WWW. FIXEDHEIGHT COM